The Jefferson County Board of Supervisors participated in a discussion about the future of mental health during its regular meeting Monday.

The discussion centered on how counties should budget for mental health, and how the state Legislature is affecting when and how counties do that.

For years, mental health services were conducted at the county level. In 2014, the state ordered counties to switch to regional care, believing that the collaboration between counties would save money and provide better services. How the counties are supposed to “regionalize” their mental health care is a complicated subject, since the entity spending the money, the region, is different from the entities generating the tax revenue, the counties.

Invited guests

Jefferson County is one of eight counties that comprise the Southeast Iowa Link region. Its board of governors is made up of one supervisor from each of the eight counties. Supervisor Dee Sandquist is Jefferson County’s representative, and she invited two people to speak at Monday’s meeting because of their knowledge of mental health issues: Ryanne Wood, coordinator of disability services for Lee County and SEIL’s appointed chief executive officer; and Tom Broeker, Des Moines County supervisor and that county’s representative on the governing board.

Senate File 504

Wood and Broeker stressed how budgeting for mental health is about to change thanks to a law passed by the Iowa Legislature last spring, Senate File 504 (also known as House File 650). In an effort to limit the property taxes counties levy to pay for mental health, the law requires counties to spend down their mental health fund. If a county has more than 20 percent of its mental health budget left at the end of the fiscal year, it will be penalized. Not only that, but every county in that region is penalized, too. The penalty is a reduction in the amount of tax the county can levy for mental health.

That’s not the only thing the supervisors are concerned about. Another problem on top of the penalty is knowing how to budget for them. Wood said counties will be assessed the penalty as soon as it occurs, on July 1 of a given year, but counties won’t know if they’ve been penalized until their audit returns several months later. In the meantime, the counties will have already gathered a round of property taxes in September using the levy they approved earlier that spring.

What happens if a county collects taxes at a certain rate, only to find out later it was penalized and should have collected less? Wood said nobody seems to know the answer to that question.

Pooling county funds

Broeker told the supervisors that he plans to ask the SEIL board of governors to pool all eight counties’ mental health funds and pay them out of one account, especially in light of Senate File 504 and the state punishing all counties in a region for the misdeeds of one.

“If one county at the end of fiscal year 2020 has 21 percent left in its ending balance, every county loses that percentage of its levying authority,” Broeker said. “If you’re trying to fund those services and all of a sudden your revenue goes down ... that’s one of the reasons budgeting needs to be done at the regional level. It’s a region responsibility, because every county is at risk if a mistake is made.”

Broeker said he will propose that every county in SEIL contribute $40 per county resident toward the regional mental health fund. He said it doesn’t matter to him whether the $40 comes from a tax levy or from that county’s reserves. He said it was the fairest way to operate, and a way to ensure counties won’t have their ending balances taken by other counties.

Fighting back

Jefferson County supervisor Lee Dimmitt said he wants the region to push back against the state mandate requiring counties to provide mental health housing. He did not believe counties were legally obligated to provide housing, because the Iowa Code says the state must fund its own mandates. Dimmitt was also curious whether the county would maintain a separate mental health account in addition to the region’s, since the region will be paying all the expenses.

“Has the region taken away mental health budgeting for counties?” he asked. “When the region levies at the cap, [the counties] are done, because you’ve got all the money.”

Dimmitt said it was time to stop going along with what the Legislature wanted and finally take the state to court.

“Blindly going along is how we got to where we are,” he said.

Dimmitt mentioned that all eight counties in the region employ a county attorney that could assist them.

After the meeting, Broeker said he’s not sure how interested the Des Moines County Attorney would be in suing the state.

“That option is not on our radar yet,” he said. “We haven’t discussed it at the [SEIL] board of governors.”

Wood said taking the state to court would be very expensive, and that one region couldn’t do it alone. She said the regions would need to band together to make that work.